长方案促排卵周期卵巢反应性与IVF-ET结局的关系  

Relationship between ovarian response and pregnancy rate in IVF-ET cycles with long protocol of controlled ovarian hyperstimulation

作　　者：赵芳 吕玉珍 王娟 田可可 

机构地区：[1]河南省焦作市妇幼保健院,454000

出　　处：《中国计划生育学杂志》2016年第11期767-771,共5页Chinese Journal of Family Planning

摘　　要：目的：探讨长方案促排卵周期中卵巢反应性与体外受精一胚胎移植（IVF-ET）结局的关系。方法：回顾性分析779个长方案促排卵IVF—ET周期的临床资料，将患者分为％35岁和≥35岁两组，每组再根据获卵数分成为个亚组，获卵数≤5个为卵巢低反应组，6～19个为正常反应组，≥20个为高反应组，比较各组一般情况和临床结局。结果：①〈35岁与≥35岁患者卵巢高反应组多囊卵巢综合征（PCOS）患者的比例高于其它两组（P〈O．05），胚胎利用率低于其它两组（P〈0．05）；②〈35岁患者低反应组的优胚率和胚胎利用率高于其他两组（P〈O．05），胚胎种植率与正常反应组无统计学差异（P〉O．05）；③不同卵巢反应各组流产率和产科结局无统计学差异（P〉O．05）。结论：长方案周期中不同卵巢反应性不影响流产率和产科结局。卵巢高反应者高雌激素水平可能影响子宫内膜的容受性而降低胚胎种植率。〈35岁的卵巢低反应者仍可获得较满意的妊娠率。Objective： To explore the relationship between ovarian response and pregnancy rate in IVF-ET cycles with long protocol of controlled ovarian hyperstimulation （COH）. Methods： The data of 779 cycles with long protocol in IVF-ET were retrospectively analyzed. According to the age of women, they were divided into two groups （≥35 years and≥35 years）. In each group according to the numbers of retrieved oocytes, the patients were allocated into three sub groups： group A.. poor responder （≥5 oocytes）, group B： normal responder （6-19 oocytes）, and group C： high re- sponder （≥20 oocytes）. The Pregnancy rate was compared among the groups. Results： @ In the high responders of 35 years group or j- 35 years group, the proportion of PCOS patients was significantly higher than that in the other two groups （P〈0.05）, while the rate of embryo available was lower than that in the other two groups （P〈0.05）. （2） In the ≥35 years group, the good quality embryo rate and embryo available rate in poor responders were significantly higher than those in the other two groups （P〈0.05）, while there was no significant difference in the rate of embryo implantation between poor responders and normal responders （P 〈0.05）. （3） There were no significant differences in blastulation rate, abortion rate and obstetric outcome among the different ovarian responders. Conclusions： The ovari- an response would not affect the embryo development potential and obstetric outcome in long protocol cycles. The high level of E2 of high responders may affect endometrial environment leading to the decrease of implantation rate. The poor ovarian responders ≥35years can achieve satisfied prelnancv rate.

关 键 词：体外受精-胚胎移植 卵巢反应性 获卵数 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]